Category Archives: Vaccinations

Minnesota’s new immunization requirements take effect Sept. 1, and with August serving as National Immunization Month, we urge parents to get their children’s vaccinations updated ahead of the upcoming school year.

The Minnesota Department of Health’s statewide requirement changes were made to protect kids from measles, whooping cough and other preventable diseases. (iStock photo / Getty Images)

The Minnesota Department of Health’s statewide requirement changes were made to protect kids from measles, whooping cough and other preventable diseases.

Getting vaccinated before September is important.

“Vaccines take about a month or so, in general, to really be full force and working for your body effectively,” Pamela “Gigi” Chawla, MD, Children’s senior medical director for primary care, said in an interview with KARE-TV. “We want kids to be ready for their school year.”

The new requirements include:

Hepatitis A and B vaccinations for children enrolling in child care or school-based early childhood programs

Two doses of measles-mumps-rubella vaccine will prevent measles in 99 percent of those vaccinated.

By Patsy Stinchfield, PNP

The confirmation of 83 cases of measles in Ohio this month and the recent quick diagnosis of a 19-month-old with measles in Minneapolis, Minnesota’s first case of measles this year, brought a timely reminder that the potentially deadly virus has not been eradicated and of the importance of vaccination. Having just wrapped World Immunization Week and National Infant Immunization Week, the importance of immunization is as great as ever.

In fact, the U.S. Centers for Disease Control and Prevention reported today that the 288 cases of measles in the country so far this year are the highest since 2000. The number of cases reported this year is the highest for the first five months of a year since 1994.

I worry that the numbers are a sign of growing credibility for a small band of celebrities and others who have thrown up an online smoke screen of fear of vaccines against measles, whooping cough and other common childhood diseases.

If even a relatively small percentage of Americans buy into this criticism, it would be disastrous. Measles, one of the most contagious airborne diseases, can be extremely serious, leading in rare cases to pneumonia and fatal brain infections. Infants too young to be vaccinated particularly are at risk.

We’re fortunate that the child in Minnesota, who actually had one of two measles shots and apparently contracted the disease during a visit to India, was diagnosed within minutes at Children’s – Minneapolis. Because the alert medical team picked up the symptoms so quickly, only 16 potentially exposed people had to be notified after the child was quarantined.

Three years ago, as many as 700 contacts had to be reached for some patients during an outbreak at Children’s.

What’s most frustrating is that it’s all so unnecessary.

The virus hasn’t changed all that much. It’s not like the HIV virus, constantly mutating. No; with measles the culprit purely is social – a breakdown in trust of medical experts whose longtime vaccine advocacy made measles and other common childhood infections a footnote.

Fear-mongering online vaccine critics are not winning, in a classical political sense. Thankfully, more than 90 percent of parents still trust their health care providers and nationally recommended vaccines. If they didn’t, we would see frequent headlines about deaths from measles, whooping cough and other diseases.

However, the remaining 10 percent of parents are hesitant, have vague fears and wonder who to trust. They routinely hear or read vehement vaccine bashing in social media circles, which feeds fear and denial – and new outbreaks. New York City and Orange County, Calif., currently are dealing with measles outbreaks.

Measles is so highly contagious that just passing through a clinic waiting room two hours after someone with measles has been there can expose an unvaccinated newborn, which may be devastating.

We all must protect the vulnerable in our community by forming a protective barrier of our own vaccination. That’s a simple point seemingly lost on the peddlers of myth and pseudoscience who have infected too many parents with baseless fear of vaccines that protect their own children and the community at large.

Parents should trust health care professionals who urge vaccination on schedule. At Children’s, we speak from experience. We have seen children die or become permanently impaired from vaccine-preventable disease. Ask our specialists how many unvaccinated, critically ill children they have cared for, and they would answer “too many to count.” And how many they’ve seen with severe vaccine side effect? You’ll get a blank stare, or “I don’t recall any; maybe one at most.”

We have seen children with measles on a ventilator, fighting for their lives. That’s a bitter sight when you recognize that two doses of measles-mumps-rubella vaccine will prevent measles in 99 percent of those vaccinated. There’s no contest between the benefits of vaccines and their extremely rare risks.

Before the measles vaccine was developed in the 1960s, there were 2.6 million measles-related deaths per year worldwide. In 2012, that number was down to 122,000, mostly in children younger than 5 in parts of the world where vaccines are scarce or their parents refuse to allow vaccination. The point is that we can’t afford to let our guard down in the U.S. or elsewhere. In a global society measles is a mere plane ride away for the unprotected.

The safe, effective and trustworthy action for infants, children, adolescents and adults is to get vaccinated on time for all recommended vaccine-preventable diseases.

I’d always been a little indifferent toward flu shots. Of course, when I was pregnant I got vaccinated and always made sure my kids got vaccinated. But, it was “when we get to the clinic, we’ll get it done” versus “we really need to get the vaccine” sort of attitude.

That is until this past winter. On New Year’s Day, my sweet little 4-year-old spiked a fever and started on a downhill health spiral, and I realized the flu shot was a lot more important than I’d ever imagined.

After a late night with friends celebrating the new year, my daughter Evelyn was tired, lethargic and feverish. We thought nothing of it seeing as she’d been up so late, eating treats and having fun. She fell asleep several times throughout the day, which was extremely out of the norm for her. She had a cold but let’s be honest, when don’t preschool aged kids have some signs of a cold going on.

That night, her fever reached 103 degrees and because that was higher than what a typical fever for her, I had a feeling we’d be visiting the doctor soon. The next day, we arrived at the pediatrician’s office with a fever of 104, along with many other post-holiday sick families. After running through her symptoms and checking her out, her doctor tested for influenza.

“Well, what do you mean? She had the flu shot.” I remember asking. And that’s when I learned that even if you get immunized, it’s still possible to get the flu. However, it may not be as bad as it would have been without the immunization.

Did you know that according to the Centers for Disease Control and Prevention there are many different influenza viruses that circulate each year? The flu shot protects against the three or four viruses that research suggests will be most common. I can’t imagine being involved in that kind of research and how hard it would be to predict what the varying strains may be.

Unfortunately, there are still cases where people get infected despite being vaccinated and Evelyn was likely one of them as she was diagnosed with Influenza B.

She spent the next several days very, very sick. At times, her fever spiked to 105 even on the Tamiflu prescription she was given, in addition to alternating ibuprofen and acetaminophen. She slept on the couch for days on end, and we pumped her full of fluids and tried to get her to eat anything fearing dehydration. It was a very scary time not knowing if her fever would continue to climb, especially during the evenings. She ended up missing over a week of her preschool.

In our case, catching her symptoms somewhat early and starting a prescription of Tamiflu, in addition to being vaccinated, helped what could have been an even more serious illness and higher fever, which was scary enough.

This year, getting vaccinated was on top of our fall checklist. Even though Evelyn became ill last winter, knowing and having watched her fight i, I would never want to risk having our family unprotected when there’s something available to help prevent influenza.

Samara Postuma is a freelance writer. Her five kids range in age from 7 months to almost 15. When she is not busy driving kids to school and activities, taking care of baby or teaching her second grader, she writes and works in social media. She blogs athttp://simplicityinthesuburbs.com. She can also be found on Twitter.

Patsy is a pediatric nurse practitioner and the director of infectious disease/immunology and infection prevention at Children’s Hospitals and Clinics of Minnesota.

The Centers for Disease Control and Prevention released a new report indicating that only about half of adolescent girls – and far fewer boys – received the first dose of the recommended HPV vaccine and only about a third have completed the three-dose series.

As a parent and a practicing clinician, the fact that many of our children are missing an opportunity to get protected against HPV, short for the human papillomavirus (a common sexually transmitted disease) and related cancers concerns me. Since the introduction of the HPV vaccine, the number of HPV cases which leads to cervical cancer cases has been cut in half. In half. That’s monumental. We know this vaccine works, and we need to use it to the fullest extent possible.

The vaccine is safe, as well. In the more than 56 million doses given thus far, no serious safety events have occurred. The most commonly reported event is fainting, which happens with other vaccines given to teens, as well, leading to our usual practice of having teens sit for 15 minutes after vaccination.

HPV infects about 79 million Americans, 14 million of whom become infected each year. About 21,000 women are affected by cancer linked with HPV, and cervical cancer is the most common. More than 4,000 women, usually in child –bearing years, die of cervical cancer. It’s also associated with other cancers, such as those that affect the throat, tongue and tonsils, in men. But, the infection that causes these cancers can be prevented with the vaccine series. What parent wouldn’t want his or her child to be protected against cancer?

The HPV vaccines are given as a series of three shots over six months to protect against HPV infection and the health problems the infection can cause, according to the CDC. Two (Cervarix and Gardasil) protect against cervical cancers in women. One (Gardasil) also protects against genital warts and cancers of the anus, vagina and vulva. Both vaccines are available for girls. Only Gardasil is available for boys.

I recommend to families that children – both boys and girls – get the vaccine well before they’re sexually active to offer the best protection. Typically, we suggest 11 or 12. And, the full series – all three shots – need to be taken in order to be truly effective.

“We don’t wait for exposure to occur before we vaccinate with any other routinely recommended vaccine,” CDC Director Dr. Thomas Frieden has said in the past.

I sometimes hear from parents that they’re worried their son or daughter will be encouraged to have sexual relations because they’ve been vaccinated. While I understand their concern, there is no link between getting vaccinated and increased sexual activity.

Unfortunately, I’ve seen first-hand the devastation that vaccine-preventable diseases cause in children who haven’t been immunized. Let’s work together to take HPV-associated cancers off that list. It’s the right thing to do.

But Pertussis, also known as “whooping cough,” is a highly contagious respiratory disease that can strike infants to the elderly. And there’s currently an epidemic underway in Minnesota.

There were 1,758 Pertussis cases reported in Minnesota as of June 30, according to the Minnesota Department of Health. More than 400 cases have been reported so far in July alone. Nationally, the number of cases could reach its highest level in 50 years, according to the Centers for Disease Control and Prevention.

Children’s Hospitals and Clinics of Minnesota saw nine Pertussis cases just this past week and 41 in the month of July, said Patsy Stinchfield, director of Infectious Disease/Immunology and Infection Prevention. The hospital typically sees 32 cases over the course of a year.

The numbers are concerning.

“Everyone should be on their toes thinking about and testing for Pertussis for people with a cough lasting more than a week,” Stinchfield said.

Pertussis can be a serious illness in infants, children and adults and can be life-threatening, especially for infants. A person with Pertussis develops a severe cough that usually lasts four to six weeks or longer, even up to 100 days. It can make it hard to breathe or cause vomiting. The “whooping” sound isn’t always present.

It’s unknown what has caused the spike in cases. While Pertussis occurs in all age groups, the average age is 14 and outbreaks have occurred in middle schools, according to the Minnesota Department of Health.

“Teens are like a perfect storm of infection,” Stinchfield said.

They may not have gotten their Tdap booster yet, and they tend to continue socializing when they’re sick, spreading their infection to others in their social groups and communities, she explained.

The good news is that Pertussis is preventable. Stinchfield offered the following tips to protect your children and yourself:

Children need their primary series of DTaP vaccinations

All adolescents and adults need a Tdap booster—one dose for anyone 10 and older

Women who are 20 or more weeks pregnant, adults who have significant contact with children and elderly need to make sure they get a Tdap booster

Thoroughly wash hands and avoid touching eyes, nose or mouth

Those who have Pertussis should not leave home until they have completed their entire antibiotic treatment which is generally five days. If no antibiotics are taken, Pertussis can spread during the first 21 days of the cough. Avoiding social contact (stay home from work, school and daycare) until five days of antibiotics are completed is essential

It’s called “The 100 day Cough” for a reason—the antibiotics reduce spread to others, but it does not repair damage in the airways which can cause the person to have a harsh cough for many weeks and even a few months

Babies too young to be immunized are the ones most likely to die from Pertussis and usually get it from their mom, dad or grandparent. Vaccinating anyone in contact with a newborn helps prevent needless tragedy

Patsy Stinchfield talks more about Pertussis by video. To watch the series, click here.

For more information or to contact a provider, please visit www.childrensmn.org.

This is a guest post by Justin Theodotou, public relations coordinator at Children’s. He accompanied Patsy Stinchfield, Children’s director of infectious disease, on a trip to New York City to speak with national media outlets about the importance of childhood vaccines.

My first trip to New York City was a short one, with little time to “see the sights.” I was there for another reason: to accompany one of Children’s most passionate providers on her quest to make kids healthier.

My travel partner for 24 hours was Patsy Stinchfield, Children’s director of infectious disease. If you’ve ever met Patsy, you feel her passion for children’s health immediately. She’s bursting at the seams with it. One area for which she carries a healthy amount of zeal is the importance of childhood vaccinations, and the purpose of our trip was to promote that very subject, and bring national attention to the work being done at Children’s.

On our agenda was back-to-back-to-back meetings with a “who’s who” list of national media outlets (The New York Times, CBS Evening News, Real Simple, etc.), booked by Children’s public relations partner, Weber Shandwick. These meetings served as an entre for Patsy as a trusted thought leader and resource on childhood vaccinations.

After arriving late on a Tuesday night, it was a taxi ride to our hotel, followed by a short walk to Rockefeller Center to snap a few photos and meet up with Patsy’s sister. We needed to be up and at ‘em early. We had a full day planned.

Our meetings on Wednesday were all different in flavor, but tended to follow two basic routes when discussing the importance of vaccinations. Sometimes, it was the basics: vaccines are safe, effective and they work. Save for clean water, vaccines have saved more lives on this planet than any other man-made creation.

Sometimes, our conversations took a philosophical turn: should today’s parents be left to sift through the information (much of it false, if you get it from the wrong places) about vaccines and whether or not to fully immunize their children? Or, should we as health care providers do a better job of listening when parents have concerns about vaccines, playing the role of trusted counselor rather than lecturer?

Patsy, ever the great storyteller, also drove home her point with anecdotal evidence. She told the story of a mother who brought her four kids to a travel clinic for vaccinations before a trip to Kenya to visit relatives. Three of the four children received the shots they needed, but when it came time for the youngest, nine-month-old Mahi, to receive his, he’d fallen asleep, and his mother didn’t want to wake him. Later, this mother would refer to this moment as her “fateful decision.” The family traveled to Kenya – an area of the world where measles is rampant – with Mahi unvaccinated.

Unfortunately, Mahi contracted the disease, which subsequently attacked his respiratory system, and spent 25 days in Children’s PICU, hooked up to a ventilator. His mom, who earlier didn’t want to wake him in the travel clinic, prayed fervently that he would wake up and that she would once again be able to hold her baby.

Thankfully, Mahi survived his fight against this often deadly vaccine-preventable disease.

I’d heard Patsy tell this story before, but when she told it during one of our meetings, it nearly brought me to tears.

After a whirlwind day zipping across Manhattan — twice inching our way through Times Square in our car — all we had time for was a quick bite to eat before hailing a taxi back to the airport.

But, this trip got me thinking. Vaccines do the job none of us can do on our own. They work to protect us from germs that are indiscriminant infectors, not caring who you are, where you live or what you had for breakfast. All these germs need is a host, and, like it or not, the human body is a darn near perfect one.

It was during this trip that I realized how thankful I am to be fully vaccinated. My parents made the choice I couldn’t as an infant. They chose to protect my sister and me, the two things most near and dear to their hearts, dispelling the worry and the “what if” had we not been vaccinated. But, they were well-informed (my mother’s a nurse), had access to a pediatrician they knew and trusted, and had health insurance, which paid for those vaccines.

Sadly, not all families are as fortunate, but, there are resources available to help them. Agencies like the Centers for Disease Control and Prevention and the American Academy of Pediatrics provide reliable vaccine information and schedules for parents and providers to follow. Finding a “medical home” is important so the same group of providers is seeing your kids regularly. The Minnesota Vaccines for Children program provides free vaccines for families who don’t have insurance to cover them.

To me, the choice to vaccinate your children is like the choice to buckle them in their car seat. Chances are you won’t get in a car accident, but is the risk really worth it?

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For more information and for a list of reliable vaccine resources, visit the Immunizations page on Children’s web site here.

Influenza is a serious respiratory illness. In 2010 alone, 122 kids died from complications from the flu—three of those children were from right here in Minnesota.

We at Children’s want to help bring that number to zero by educating the public and by providing families access to flu vaccinations.

Help us spread the word by sharing this infographic. Getting the flu vaccine will help protect you, your child, and reduce these numbers—it’s never too late to make sure your child is vaccinated.

Children’s Hospitals and Clinics of Minnesota have programs and services to support influenza prevention. For more facts about the flu and the programs we offer, visit: http://www.childrensmn.org/services/flu/

Influenza prevention education is an important step to keeping kids healthy during the flu season. That is why the Kohl’s Cares for Kids program awarded Children’s a $441,259 grant in 2009, a $422,000 grant in 2010 and a $483,230 grant in 2011 to create the Kohl’s and Children’s Influenza Prevention Project for Kids. The project offers free vaccination clinics and educational assemblies in schools to teach children about flu prevention.

Patsy Stinchfield, Children’s director of pediatric infectious disease, was quoted in USA Today on the current measles outbreak affecting the U.S. Two Children’s patient families who dealt with measles are also featured in the article.

The Minnesota Department of Health recently declared the measles outbreak in Minnesota over.

Minnesota has long been a leader in childhood vaccination rates. But with success has come complacency. The recent outbreak of now 23 cases of measles in Minnesota has brought to light the serious consequences of stagnant or declining vaccination rates.

Simply put, now is the time to stand up and voice our support for childhood vaccinations.

Our desire to increase vaccination rates – and decrease vaccine-preventable disease among our children – led to this week’s Minnesota Vaccination Awareness Forum, which we had the pleasure to co-lead today.

The forum was another great example of how public, private, and community organizations can come together to tackle an issue directly impacting our state. The goal of the forum was to kick-off a statewide call to action to rally parents, providers and communities around the critical importance of vaccination in protecting public health. We wanted to clear up myths and misconceptions about vaccines, while providing ideas on how to improve vaccination rates.

The forum featured a group of both national and local vaccination experts. We were honored to host Dr. Martin G. Myers, emeritus professor of the University of Texas Medical Branch at Galveston and director of the National Network for Immunization Information.

The panel at the Minnesota Vaccination Awareness Forum.

Locally, both Dr. Edward Ehlinger, Minnesota Department of Health commissioner, and Dr. Robert Jacobson, chair of the Immunization Task Force of the Minnesota Chapter of American Academy of Pediatrics, were on hand to provide their insight into vaccination trends in Minnesota.

But the speakers that stole the hearts of the day were the two Minnesota mothers and vaccination advocates – Brendalee Flint and Hodan Hassan – who told their own courageous and emotional stories. Brendalee told the tale of how her young daughter nearly died after a Hib outbreak in 2008, while Hodan discussed the impact that misinformation about vaccines has had on the Somali community. They pleaded with attendees to dismiss the myths and understand the devastating impact that delaying or opting out of vaccines can have on children.

If there was one message that rang loud and clear, it was that we all have a responsibility to ensure every Minnesota child is safe from vaccine-preventable disease.

Let’s make a pledge to link arms in this effort to gain “best in the nation status” on our vaccination rates – whether we are parents, health care providers or lawmakers. Our state needs to lead by example, and again become a leader in childhood vaccination.

Congresswoman Betty McCollum serves on the House Appropriations and Budget Committees.

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